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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372001020
Report Date: 10/13/2023
Date Signed: 10/13/2023 01:02:41 PM

Document Has Been Signed on 10/13/2023 01:02 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:COLLEGE AVENUE PRE-SCHOOLFACILITY NUMBER:
372001020
ADMINISTRATOR:LARA BLOUINFACILITY TYPE:
850
ADDRESS:4747 COLLEGE AVENUETELEPHONE:
(619) 583-7111
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 180TOTAL ENROLLED CHILDREN: 208CENSUS: 136DATE:
10/13/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Director, Lara BlouinTIME COMPLETED:
01:15 PM
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On 10/13/23 at 10:45am, an unannounced case management inspection was conducted by Licensing Program Analyst (LPA) Saraliz Velando to follow up on two incident reports that occurred on 9/27/23 and 10/10/23. Upon arrival, LPA met with Director, Lara Blouin. A tour of the facility was conducted, and LPA observed 136 preschool children in care and 24 staff.

The facility self-reported the first incident to the department on 9/28/23. During the incident a preschool child climbed a play structure and was told not to climb higher, she jumped off and landed on her hands and complained of pain a few minutes later. According to staff, the child did not cry immediately and was provided an ice pack, then she started crying from pain to her left wrist. The child was picked up by a parent. The second incident was also self-reported to the department on 10/10/23. During the incident, the child was rolling a truck around the rim of a sandbox, stumbled, and hit his right eyebrow on the edge of the sandbox and sustained a small laceration. A staff member provided first aid while the parent picked him up.

The Director and two staff members were interviewed and based on the information; it appears that there was enough staff to provide supervision to ensure safety of the children in the outdoor play area. The two incidents were reported in a timely manner.

There were no deficiencies cited today. Facility was provided a copy of the appeal rights.

Exit interview was conducted and report was reviewed with Director, Lara Blouin.

A notice of site visit was given and observed posted, this notice shall remain posted for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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